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Risk of cutaneous herpes zoster in patients with spondyloarthritis treated with conventional and biologic disease-modifying antirheumatic drugs.

Abstract

OBJECTIVES

To investigate the risk of cutaneous herpes zoster (HZ) in spondyloarthritis (SpA) compared with that in rheumatoid arthritis (RA), and in disease-modifying antirheumatic drugs (DMARDs) used in SpA.

METHOD

A total of 727 patients with an expert diagnosis of SpA were identified retrospectively from four rheumatology centers in Hong Kong. Electronic medical records from 1995 to 2018 were reviewed for incidence of cutaneous HZ and demographic data including age, sex, comorbidities, smoking and drinking status. DMARDs used included sulphasalazine, methotrexate, leflunomide, steroids, etanercept, infliximab, adalimumab, golimumab, secukinumab and ustekinumab. Cox regression models were used to evaluate hazard ratios (HRs) of different DMARDs in patients with SpA. Propensity score was used for matching and comparison with 857 patients with RA.

RESULTS

There were 23 cases of cutaneous HZ in patients with SpA and 59 cases in patients with RA. Among patients with SpA, 7 cases of cutaneous HZ may be attributed to sulfasalazine treatment, 7 to methotrexate, 2 to leflunomide, 2 to infliximab, 1 to etanercept, 2 to adalimumab, and 1 to secukinumab. Risks of cutaneous HZ were the same in SpA (stratified HR 0.97; 95% CI 0.58; 1.61; P = .89) and RA. Methotrexate (adjusted HR 3.47; 95% CI 1.25; 9.63; P = .02) and infliximab (adjusted HR 10.67; 95% CI 1.37; 82.88; P = .02) were found to be associated with HZ after adjustments for traditional risk factors.

CONCLUSION

Risk of cutaneous HZ in SpA was not lower than in RA. Methotrexate and infliximab were associated with cutaneous HZ in SpA.

Authors+Show Affiliations

Division of Rheumatology and Clinical Immunology, The University of Hong Kong, Hong Kong, China.School of Public Health, The University of Hong Kong, Hong Kong, China.Division of Rheumatology, Caritas Medical Center, Hong Kong, China.Division of Rheumatology and Clinical Immunology, The University of Hong Kong, Hong Kong, China.Division of Rheumatology and Clinical Immunology, The University of Hong Kong, Hong Kong, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31489783

Citation

Wong, Sabrina Ching Tung, et al. "Risk of Cutaneous Herpes Zoster in Patients With Spondyloarthritis Treated With Conventional and Biologic Disease-modifying Antirheumatic Drugs." International Journal of Rheumatic Diseases, 2019.
Wong SCT, Li IWS, Ng AHY, et al. Risk of cutaneous herpes zoster in patients with spondyloarthritis treated with conventional and biologic disease-modifying antirheumatic drugs. Int J Rheum Dis. 2019.
Wong, S. C. T., Li, I. W. S., Ng, A. H. Y., Lau, C. S., & Chung, H. Y. (2019). Risk of cutaneous herpes zoster in patients with spondyloarthritis treated with conventional and biologic disease-modifying antirheumatic drugs. International Journal of Rheumatic Diseases, doi:10.1111/1756-185X.13694.
Wong SCT, et al. Risk of Cutaneous Herpes Zoster in Patients With Spondyloarthritis Treated With Conventional and Biologic Disease-modifying Antirheumatic Drugs. Int J Rheum Dis. 2019 Sep 6; PubMed PMID: 31489783.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of cutaneous herpes zoster in patients with spondyloarthritis treated with conventional and biologic disease-modifying antirheumatic drugs. AU - Wong,Sabrina Ching Tung, AU - Li,Iris Wai Sum, AU - Ng,Alexandra Hoi Yan, AU - Lau,Chak Sing, AU - Chung,Ho Yin, Y1 - 2019/09/06/ PY - 2019/04/12/received PY - 2019/08/06/revised PY - 2019/08/08/accepted PY - 2019/9/7/entrez KW - DMARD KW - herpes zoster KW - infliximab KW - methotrexate KW - rheumatoid arthritis KW - spondyloarthritis JF - International journal of rheumatic diseases JO - Int J Rheum Dis N2 - OBJECTIVES: To investigate the risk of cutaneous herpes zoster (HZ) in spondyloarthritis (SpA) compared with that in rheumatoid arthritis (RA), and in disease-modifying antirheumatic drugs (DMARDs) used in SpA. METHOD: A total of 727 patients with an expert diagnosis of SpA were identified retrospectively from four rheumatology centers in Hong Kong. Electronic medical records from 1995 to 2018 were reviewed for incidence of cutaneous HZ and demographic data including age, sex, comorbidities, smoking and drinking status. DMARDs used included sulphasalazine, methotrexate, leflunomide, steroids, etanercept, infliximab, adalimumab, golimumab, secukinumab and ustekinumab. Cox regression models were used to evaluate hazard ratios (HRs) of different DMARDs in patients with SpA. Propensity score was used for matching and comparison with 857 patients with RA. RESULTS: There were 23 cases of cutaneous HZ in patients with SpA and 59 cases in patients with RA. Among patients with SpA, 7 cases of cutaneous HZ may be attributed to sulfasalazine treatment, 7 to methotrexate, 2 to leflunomide, 2 to infliximab, 1 to etanercept, 2 to adalimumab, and 1 to secukinumab. Risks of cutaneous HZ were the same in SpA (stratified HR 0.97; 95% CI 0.58; 1.61; P = .89) and RA. Methotrexate (adjusted HR 3.47; 95% CI 1.25; 9.63; P = .02) and infliximab (adjusted HR 10.67; 95% CI 1.37; 82.88; P = .02) were found to be associated with HZ after adjustments for traditional risk factors. CONCLUSION: Risk of cutaneous HZ in SpA was not lower than in RA. Methotrexate and infliximab were associated with cutaneous HZ in SpA. SN - 1756-185X UR - https://www.unboundmedicine.com/medline/citation/31489783/Risk_of_cutaneous_herpes_zoster_in_patients_with_spondyloarthritis_treated_with_conventional_and_biologic_disease-modifying_antirheumatic_drugs L2 - https://doi.org/10.1111/1756-185X.13694 DB - PRIME DP - Unbound Medicine ER -